Healthcare Provider Details

I. General information

NPI: 1104825868
Provider Name (Legal Business Name): HARVEY ALLEN DAVIS L.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MYERS ST
LEXINGTON VA
24450-2040
US

IV. Provider business mailing address

241 GREENHOUSE RD ATTN: STEPHANIE RHODENIZER
LEXINGTON VA
24450-3717
US

V. Phone/Fax

Practice location:
  • Phone: 540-463-3141
  • Fax: 540-463-9662
Mailing address:
  • Phone: 540-464-3395
  • Fax: 540-464-4051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0710000295
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904003777
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: